Trends in guideline implementation: an updated scoping review

Peters, S (通讯作者),Univ Leuven, Dept Publ Hlth & Primary Care, Leuven, Belgium.
2022-7-23
Background: Guidelines aim to support evidence-informed practice but are inconsistently used without implementation strategies. Our prior scoping review revealed that guideline implementation interventions were not selected and tailored based on processes known to enhance guideline uptake and impact. The purpose of this study was to update the prior scoping review. Methods: We searched MEDLINE, EMBASE, AMED, CINAHL, Scopus, and the Cochrane Database of Systematic Reviews for studies published from 2014 to January 2021 that evaluated guideline implementation interventions. We screened studies in triplicate and extracted data in duplicate. We reported study and intervention characteristics and studies that achieved impact with summary statistics. Results: We included 118 studies that implemented guidelines on 16 clinical topics. With regard to implementation planning, 21% of studies referred to theories or frameworks, 50% pre-identified implementation barriers, and 36% engaged stakeholders in selecting or tailoring interventions. Studies that employed frameworks (n=25) most often used the theoretical domains framework (28%) or social cognitive theory (28%). Those that pre-identified barriers (n=59) most often consulted literature (60%). Those that engaged stakeholders (n=42) most often consulted healthcare professionals (79%). Common interventions included educating professionals about guidelines (44%) and information systems/technology (41%). Most studies employed multi-faceted interventions (75%). A total of 97 (82%) studies achieved impact (improvements in one or more reported outcomes) including 10 (40% of 25) studies that employed frameworks, 28 (47.45% of 59) studies that pre-identified barriers, 22 (52.38% of 42) studies that engaged stakeholders, and 21 (70% of 30) studies that employed single interventions. Conclusions: Compared to our prior review, this review found that more studies used processes to select and tailor interventions, and a wider array of types of interventions across the Mazza taxonomy. Given that most studies achieved impact, this might reinforce the need for implementation planning. However, even studies that did not plan implementation achieved impact. Similarly, even single interventions achieved impact. Thus, a future systematic review based on this data is warranted to establish if the use of frameworks, barrier identification, stakeholder engagement, and multi-faceted interventions are associated with impact.
IMPLEMENTATION SCIENCE
卷号:17|期号:1
ISSN:1748-5908|收录类别:SCIE
语种
英语
来源机构
University of Melbourne; KU Leuven; University of Toronto; Jawaharlal Institute of Postgraduate Medical Education & Research; State University of New York (SUNY) System; State University of New York (SUNY) Stony Brook; University of Adelaide; South African Medical Research Council; Sheffield Hallam University; King Saud University; King Saud University; Egyptian Knowledge Bank (EKB); Alexandria University; University of Toronto; University Health Network Toronto
资助机构
Scottish Charity
资助信息
The Guidelines International Network (GIN; www.g-i-n.net), which is a Scottish Charity, recognized under Scottish Charity Number SC034047, provided support for collaboration of the authors. The GIN Board of Trustees had an opportunity to comment on this paper, but did not have any role in development or preparation of the manuscript for publication.
被引频次(WOS)
2
被引频次(其他)
2
180天使用计数
4
2013以来使用计数
4
出版年
2022-7-23
DOI
10.1186/s13012-022-01223-6
学科领域
循证公共卫生
关键词
Guidelines Implementation interventions Implementation strategies Quality improvement Scoping review
WOS学科分类
Health Care Sciences & Services Health Policy & Services